How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $446.68 Median $4,466.84 Typical High $8,128.31 | Facility | None | $446.68 | $4,466.84 | $8,128.31 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $501.19 | Professional | None | $446.68 | $446.68 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,311.31 Median $5,370.32 Typical High $9,332.54 | Facility | None | $3,311.31 | $5,370.32 | $9,332.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $512.86 Typical High $912.01 | Professional | None | $416.87 | $512.86 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $17,782.79 | Facility | None | $1,479.11 | $3,467.37 | $17,782.79 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $691.83 | Professional | None | $354.81 | $354.81 | $691.83 |
Hometown Health Setting Professional Modifier None Typical Low $7.24 Median $436.52 Typical High $691.83 | Professional | None | $7.24 | $436.52 | $691.83 |
Hometown Health Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
Hometown Health Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $588.84 | Professional | None | $6.31 | $6.31 | $588.84 |
Select Health Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $4,265.80 | Facility | None | $389.05 | $389.05 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
United Setting Facility Modifier None Typical Low $1,905.46 Median $3,019.95 Typical High $6,456.54 | Facility | None | $1,905.46 | $3,019.95 | $6,456.54 |
United Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $707.95 | Professional | None | $389.05 | $457.09 | $707.95 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | 52 · Reduced service | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 53 · Discontinued | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | 54 · Surgery only | $338.84 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | 78 · Unplanned return to OR | $316.23 | $316.23 | $316.23 |
Where Nevada sits
The same service costs 9.5 times more in Oklahoma than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Nevada· 37th of 51
$575
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.